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Migrainous infarction

Chia-Chun Chiang1, Shih-Pin Chen2

  • 1Department of Neurology, Mayo Clinic, Rochester, MN, United States.

Handbook of Clinical Neurology
|February 2, 2024
PubMed

Insights

Migrainous infarction, a rare stroke type linked to migraine with aura, affects younger patients with fewer traditional risk factors. Early diagnosis and specific therapies are crucial for managing this condition.

Area of Science:

  • Neurology
  • Vascular Neurology

Background:

  • Migrainous infarction represents a complex intersection of migraine and stroke.
  • Understanding this association is critical for accurate diagnosis and management.
  • It is an extreme manifestation of the migraine-stroke link.

Approach:

  • This chapter explores the multifaceted relationship between migraine and stroke.
  • It reviews increased stroke risks in migraine patients and stroke triggers in migraineurs.
  • The progression of stroke in migraine patients and associated clinical conditions are discussed.

Key Points:

  • The annual incidence of migrainous infarction is approximately 0.80 per 100,000 person-years, with higher rates in females.
  • Patients are typically younger (29-39 years) and have fewer traditional vascular risk factors.
  • Prognosis can be more favorable compared to strokes related to traditional risk factors.

Conclusions:

  • Thorough evaluation is essential to exclude other stroke causes.
  • Recommended treatments include antiplatelet therapy and migraine preventive strategies.
  • Vasoactive medications like triptans and ergots should be avoided in patients with migrainous infarction.
Keywords:
Cardioembolic strokeEndothelial dysfunctionMigraine and strokeMigraine with auraMigrainous infarctionOral contraceptivesPatent foramen ovaleSpreading depolarizationVasospasm

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